PRIMARY PROGRESSIVE APHASIA SYNDROME

Abstract

Primary progressive aphasia (PPA) syndrome is a complex of isolative progressive speech disorders without or with minimal other cognitive disorders. The scientists are looking for reliable biomarkers of PPA- such as neuropsychologic, neuroimaging markers that give opportunity of life-time syndromal and nosologic diagnosis of PPA and find symptomatic and pathogenic therapy. Purpose: to study symptoms, neuropsychological parameters and treatment options of some independent forms of PPA. Patients and methods: Sixteen (16) patients at age from 38 till 78 years old (mean age 61,6+10,2) passed neurological and neuropsychological examination. We used the following neuropsychological tests: mini-mental state examination, Frontal assessment battery, clock drawing test, verbal fluency test (semantic and phonemic),Bostonnaming test, the Greber-Buschke memory test “12words”. Thirteen patients with PPA had MRI ( T1, T2 weighted images and Flair). Eight (8) patients with PPA have been treated for 11,7+9,4 months (7 patients with memantine and one patient received combined therapy with memantine and anticholinesterase inhibitors). The results were statistically analyzed with SPSS 17.0 using non-parametric Wilcoxon- Mann-Whitney test. Results: we revealed that patients with agrammatic form PPA had predominantly decreased speech fluency; the patients with semantic form had anomia, auditory and verbal memory disorder, spatial and object recognition memory loss. Patients with logopenic form of PPA had anomia and object recognition memory loss. Monotherapy with memantine or combined therapy with AChE were ineffective. Conclusion. Taking into account heterogeneity of PPA syndrome differential approach to the management in consideration with nosological entity is essential.